Leave of Absence during the COVID-19 Pandemic: Drivers and Policies

The worker shortage is a critical and multifaceted challenge in the health systems (1, 2). Nevertheless, after the outbreak of the COVID-19 pandemic in 2019, the demand for healthcare workers in the hospital and healthcare sector has become more intense; the worker shortage has reached a warning threshold (3). The imbalance between supply and demand workers in health systems, on the one hand, and the increasing requests for leave of absences, a behavioral response to COVID-19, on the other hand, have exacerbated the crisis. Evidence shows that the demand for leave has increased among healthcare workers (4). Since the COVID-19 pandemic, in addition to the usual reasons for requesting leave, some risks have exacerbated this behavior; these risks include fear of contracting infectious diseases and transmission of the virus to their family and friends, risk of increase in the patient violence (5), risk of experiencing guilt following the death of a patient (6), and risk of excessive work demand. While such leaves lead to a break in the chain of COVID-19, as a hidden aspect of absenteeism, they can result in individual and organizational costs such as productivity losses, turnover, presenteeism, economic cost of providing paid sick leave, and reduction of the quality of health services. Increasing demand for leave has intensified the nursing shortage in healthcare and that creates an undesirable and stressful workplace environment (7).Leave of absence, as a right for workers, is recognized in most countries, not only when the economy is open, but also during a lockdown (8). Despite the conflict between the need to reduce the spread of the COVID-19 and the need for human contact, especially in healthcare and hospitality sector, it is necessary to identify these factors; thereare key policies that can benefit both. Regardless of the type of leave (paid/unpaid) and the reasons it (a worker’s physical or mental health problems, etc.), it is complex and explained by individual, occupational and organizational factors (3, 4, 9-13). The main aim of this letter to editor is to introduce the most important drivers of leave of absence and suggest critical policies to manage them. For this purpose, the research literature was reviewed. Table 1 shows the factors affecting the number of workers’ leave and policies to manage them.